Transcript of March 2013 #urojc

#urojc transcript

Healthcare Social Media Transcript

From: Sun Mar 03 12:00:00 PST 2013
To: Tue Mar 05 16:00:00 PST 2013
iurojc
Let the March #urojc begin Discussion is on quality if life in patients with small renal masses being managed conservatively

iurojc
Reminder that #urojc paper for March is now available for free download at http://t.co/aeW9htbGpg Don’t forget hashtag #urojc on every tweet

DovePress
RT @iurojc: Let the March #urojc begin Discussion is on quality if life in patients with small renal masses being managed conservatively

iurojc
#urojc Have we underestimated the impact of illness uncertainty as we push to awards conservative management?

linton_kate
@iurojc #urojc makes a great case for more onc nurse specialists and more t needed for counselling. Wonder abt diff in biopsy vs no biopsy

iurojc
For quick review & reminder of topic, see attached abstract #urojc http://t.co/vhYoz7freJ

iurojc
RT @linton_kate@iurojc #urojc makes a great case for more onc nurse specialists and more t needed for counselling. Wonder abt diff in …

DovePress
RT @linton_kate@iurojc #urojc makes a great case for more onc nurse specialists and more t needed for counselling. Wonder abt diff in …

DovePress
RT @iurojc: For quick review & reminder of topic, see attached abstract #urojc http://t.co/vhYoz7freJ

StorkBrian
RT @iurojc: For quick review & reminder of topic, see attached abstract #urojc http://t.co/vhYoz7freJ

UrologyMatch
How Twitter has helped me become a better doctor http://t.co/WFZPHFRsjA via @imedicalapps #urojc

iurojc
#urojc RT“@UrologieTwente@iurojc probably interesting to evaluate for prostate cancer patiënts in an Active surveillance protocol”

iurojc
Parker: “Illness uncertainty predicted general QOL, cancer specific QOL, and intrusive thoughts and avoidance behaviors” #urojc

iurojc
#urojc MT“@UrologieTwente: Underest impact of illness uncertainty as push towards conservative management?” Where do I find the answer?

DrHWoo
Reminder to all participants to include the hashtag #urojc in all discussion tweets – in this way your tweets will be seen. Thanks #urojc

DrHWoo
#urojc Average age of patients with SRMs was 72 years. Can imagine illness uncertainty issues greater in younger patients.

daviesbj
#urojc nobody died of illness uncertainty #deepdaviesthoughts

daviesbj
#urojc not having minorities represented in this cohort is a major problem

DrHWoo
But poor QOL probably sucks & could go on for years RT @daviesbj#urojc nobody died of illness uncertainty #deepdaviesthoughts #urojc

daviesbj
#urojc isn’t this publication from Texas? Pretty sure they have a robust minority community. este ensayo es parcial

daviesbj
#urojc Me pregunto por qué los hispanos no participar en la encuesta? #deepdaviesthoughts

iurojc
Yes, MD Anderson MT“@daviesbj#urojc isn’t this publ from Texas? Pretty sure they have a robust minority community. este ensayo es parcial

StorkBrian
@iurojc @DrHWoo I am surprised that the number of patients undergoing renal biopsy was so low. #urojc

StorkBrian
@DrHWoo @iurojc Also, of those biopsied, I am surprised to find the rate of RCCa detection so low #urojc

NatriceR
RT @UrologyMatch: How Twitter has helped me become a better doctor http://t.co/WFZPHFRsjA via @imedicalapps #urojc

DovePress
RT @StorkBrian@iurojc @DrHWoo I am surprised that the number of patients undergoing renal biopsy was so low. #urojc

lasenorarivera
RT @UrologyMatch: How Twitter has helped me become a better doctor http://t.co/WFZPHFRsjA via @imedicalapps #urojc

linton_kate
@StorkBrian @iurojc #urojc may be because of co-morbidities, 88 underwent ww due to age/co-morbidities

nickbrook12
#urojc what of QOL in pnx or radical nx patients with concerns of recurrence or renal failure? Lack of comparison makes study very weak

StorkBrian
@iurojc @DrHWoo Also, a Big Thanks to our Sponsor! @DovePress #urojc

iurojc
RT @nickbrook12#urojc what of QOL in pnx or radical nx patients with concerns of recurrence or renal failure? Lack of comparison makes …

DrHWoo
@nickbrook12 Probably would be an interesting next step but this is first time detailed illness uncertainty/QOL studied with SRMs #urojc

DrHWoo
http://t.co/eDTeZAibXM MT @daviesbj#urojc Me pregunto por qué los hispanos no participar en la encuesta? #urojc

StorkBrian
@DrHWoo @iurojc Curious to what degree you think a negative renal biopsy on a small renal mass would impact illness uncertainty. #urojc

DrHWoo
@StorkBrian Negative biopsy doesn’t absolutely rule out RCC. Are those more likely to get biopsies self selecting – more anxious? #urojc

sivanrij
#urojc interesting no deaths and no one came off WW at 2 years. Is part of the Clinical significance of unknowingness changing to active tx?

nickbrook12
@DrHWoo agree absolutely. But can’t conclude too much from this study because of its design #urojc

StorkBrian
@DrHWoo @iurojc That same question may apply to our prostate cancer patients as well #urojc

matthayn
What about cancer outcomes? Can we assume everybody did great? #urojc

UrologieTwente
@nickbrook12 study points out an interesting issue that has’nt been well described for urologic cancers and Active Surveillance #urojc

DovePress
RT @nickbrook12#urojc what of QOL in pnx or radical nx patients with concerns of recurrence or renal failure? Lack of comparison makes …

DovePress
RT @StorkBrian@iurojc @DrHWoo Also, a Big Thanks to our Sponsor! @DovePress #urojc

matthayn
Of course patients were uncertain. But did that influence any intervention? What was the reason for biopsy? #urojc

StorkBrian
@matthayn @DrHWoo @urojc Agree, I think this is a very good question. Patient anxiety, physician anxiety, or protocol? #urojc

StorkBrian
@iurojc A great topic of study would be how much anxiety does following a small renal cause the urologist? #urojc

_TheUrologist_
@StorkBrian @DrHWoo @iurojc a negative SRM Bx should not reassure – 80% or repeat biopsy shows RCC http://t.co/H9LbGCvyfl #urojc

daviesbj
#urojc Estoy harto de estudios centrados en blanco ancianos. vivimos en una sociedad multicultural

nickbrook12
@UrologieTwente agree. Just hope that QOL concern from 1 study doesn’t steer some urols from AS which is powerful tool for right pt #urojc

UrologieTwente
@nickbrook12 can not agree more for prostate cancer. Little less for smal RCC’s (because of kidney sparing techniques) #urojc

nickbrook12
@UrologieTwente fair point. But pn still major intervention with 20% grade 3/4 complication rate #urojc #gu13

urorao
#urojc QoL is an issue when there is life! Recent study shows AS better than Surgery! http://t.co/rj34rGW6Iy

DrRKSingaltegh
just checking in to #urojc

DrRKSingaltegh
@StorkBrian @iurojc @DrHWoo I suspect from 2006 to now you would probably see more biopsies. Certainly true with me #urojc

captfun99
#urojc @uretericbud how about competing risks in a 72 year old with a srm? Not much uncertainty if small. almost @lifeexpectancy!

DrRKSingaltegh
@StorkBrian @matthayn @DrHWoo @urojc And how well things were communicated. #urojc

urorao
#urojc Similar uncertainties ver first reported in AS for Ca Prostate! http://t.co/YfkwtxH99u

DrRKSingaltegh
certainly 4 elderly MT @urorao#urojc QoL is an issue when there is life! Recent study shows AS better than Sx! http://t.co/ugBcoeyYp6

StorkBrian
@_TheUrologist_ @drhwoo Points well taken Data from Ann Arbor that may + 2 or distract from the discussion http://t.co/ymb85MmJEL #urojc

urorao
#urojc Mark Litwin, father of QoL has shown that QoL in AS for prostate cancer still remains after 5years! http://t.co/cVHnGRJwiZ

DovePress
RT @StorkBrian@iurojc A great topic of study would be how much anxiety does following a small renal cause the urologist? #urojc

DrRKSingaltegh
@linton_kate @iurojc Agree, More of multidisciplinary approach leads to better communication. #urojc

nickbrook12
#urojc any ideas how we fund “targeted psychological interventions” for SRM pts in the Aus public health system?

OncLive
RT @DrRKSingaltegh: certainly 4 elderly MT @urorao#urojc QoL is an issue when there is life! Recent study shows AS better than Sx! ht …

StorkBrian
@_TheUrologist_ @drhwoo @iurojc This one as well out of the Department of Urology http://t.co/T4kG1h2KTp #urojc

urorao
#urojc Limitations – there was no structured or std’ized counseling/advice plan for discussing management approaches. Take Home Msg-Counsel!

DrRKSingaltegh
Excellent point MT @_TheUrologist_@StorkBrian @DrHWoo even with negative SRM Bx -80% on repeat Bx- RCC http://t.co/0tStfk4Cl9 #urojc

DrRKSingaltegh
@_TheUrologist_ @StorkBrian @DrHWoo @iurojc Bx especially of value when positive #urojc

UrologieTwente
@nickbrook12 true, complication rate is probably lower in expert centra and with cryo / rfa ablation, good options for small leasions #urojc

urorao
#urojc If considering bx, multiple areas to be sampled. Preop bx-limited ability to identify non-clear-cell histology http://t.co/bYwSSyZ3DJ

DrRKSingaltegh
@UrologieTwente @nickbrook12 Dont get bogged down by who Rx. Certainly AS fine 4 some.Cant imagine this will drive Uros 2 change #urojc

DrRKSingaltegh
@UrologieTwente @nickbrook12 We need to communicate better and manage the anxiety #urojc

DrRKSingaltegh
Is anyone else struck by fact that our 2 big GU cancers now part of AS debates? We really did overtreat for a long time #urojc

nickbrook12
@DrRKSingaltegh @UrologieTwente nail on the head! “targetted intervention” is a reassuring subspecialist engaging patient #urojc

StorkBrian
@DrRKSingaltegh FYI PEI is on my Bucket List! #urojc

DovePress
RT @nickbrook12#urojc any ideas how we fund “targeted psychological interventions” for SRM pts in the Aus public health system?

uretericbud
@captfun99 goal is to be able to quantitate risk. we r not quite there: http://t.co/1MngW85eGo http://t.co/UyCd1hI0Xo #urojc

uretericbud
@DrRKSingaltegh have to be extremely careful c these data. “no treatment” SEER group not same as true AS group in clinical practice. #urojc

UrologyMatch
@urorao depends whom you ask http://t.co/ezIIQ6nc92 @_TheUrologist_ thoughts regarding experience from this group? #toogoodtobetrue?#urojc

uretericbud
@urorao depends whom you ask:http://t.co/zmWytLWrCU … @_TheUrologist_ thoughts re this group’s experience? #toogoodtobetrue#urojc

matthayn
Yes indeed. See RPCI experience @uretericbud @urorao @_theurologist_ http://t.co/CRrIdZQ09U #urojc

_TheUrologist_
@uretericbud @urorao 1/3 Toronto series (n=345; 67%CC, 26%pap 7%chr) Surg path on 74; 86% subtype concordance. #urojchttp://t.co/H9LbGCvyfl

_TheUrologist_
@uretericbud @urorao 2/3 grade blurrier; only 64% graded. 9.9% F3, 0 F4. Only 8/61 F3 in above series (tough 2 say “highly accurate”) #urojc

_TheUrologist_
@uretericbud @urorao 3/3 in Toronto series, as usual ~80% successful, ~80% malignant. Does that mean “NNBx”=6.25 to find one benign? #urojc

uretericbud
@_TheUrologist_ @urorao Dx of “benign” in frail / elderly = #gamechanger #urojc

_TheUrologist_
RT @uretericbud@_TheUrologist_ @urorao Dx of “benign” in frail / elderly = #gamechanger #urojc

DrRKSingaltegh
@uretericbud @_TheUrologist_ @urorao I agree. I think that is the real value of biopsy. “benign” helps build the case 4 AS in frail #urojc

_TheUrologist_
2. SRMs are often benign. ~20% if <4cm (50% if <1cm) #urojc http://t.co/5yl3EI7yJZ

DrRKSingaltegh
Not to forget though that point of this paper is QofL.1.Yes anxiety exists, 2.We need to communicate better 3.Rx who we should #urojc

_TheUrologist_
3. SRMs tend to grow slowly, ~0.25cm/yr. (But variation is large, and some will grow rapidly, so must watch) #urojc http://t.co/eW3LPY6dRz

DrRKSingaltegh
@matthayn @uretericbud @urorao @_theurologist_ These seem to be bigger masses #urojc

_TheUrologist_
4. SRMs are very unlikely to present with metastatic dz #urojc http://t.co/p446gED2Sy http://t.co/l8jdnJ0pW9

_TheUrologist_
5. Surveyed SRMs are not likely to progress to mets #urojc @uretericbud @Marc_Smaldone http://t.co/vWCwELP1Ke

uretericbud
@_TheUrologist_ @Marc_Smaldone Yup. Looks like rapid kinetics are ominous (but benigns can exhibit those as well). #urojc

DrRKSingaltegh
@_TheUrologist_ @uretericbud @Marc_Smaldone Excellent summary Mike. Thanks #urojc

_TheUrologist_
6. SRM biopsy is helpful. ~80% diagnostic, ~20% benign. NNBx~7 to find 1 benign (if pathologist happy with benign call) #urojc

_TheUrologist_
@uretericbud @Marc_Smaldone true, growth lines in CDN series parallel for benign v malignant #urojc

iurojc
RT @_TheUrologist_@uretericbud @Marc_Smaldone true, growth lines in CDN series parallel for benign v malignant #urojc

dytcmd
@DrRKSingaltegh @uretericbud @_theurologist_ @urorao I think no bx is right if AS due to age/illness. If bx +, AS hard for pt 2 cont #urojc

_TheUrologist_
7. Lastly, elderly or infirm patients are likely to expire from other causes, with SRM in situ @uretericbud #urojc http://t.co/6oiqd7GNJV

_TheUrologist_
@dytcmd @DrRKSingaltegh @uretericbud @urorao agree – if no Tx planned, no sense in Bx #urojc

purdy_eve
This is a nice, brief review of SRM before the GU exam Thursday. Thanks #urojc. Have fun up there @_TheUrologist_

dytcmd
@_TheUrologist_ @drrksingaltegh @uretericbud @urorao Esp since majority of bx still expected to be + for RCC #urojc

dytcmd
@DrRKSingaltegh I’m curious how these scores compare to matched pts of comorbidity and no renal mass–there is no control grp #urojc

_TheUrologist_
@dytcmd @DrRKSingaltegh @uretericbud @urorao some say IDing high grade is Bx rationale; I think Bx best if motivated to find benign #urojc

dytcmd
@_TheUrologist_ @drrksingaltegh @uretericbud @urorao But grading poor on most bx series. And if pt too sick to rx, does grade matter? #urojc

_TheUrologist_
8. Despite all this, small RCC is still cancer, and lethal when horse leaves the barn. #urojc

DrRKSingaltegh
@dytcmd Agreed. Paper suggests simply that worry/anxiety exist #urojc

DrRKSingaltegh
Novel #meded in progress! MT @purdy_eve: This is a nice, brief review of SRM before the GU exam Thursday. Thanks #urojc@_TheUrologist_

iurojc
RT @_TheUrologist_@dytcmd @DrRKSingaltegh @uretericbud @urorao agree – if no Tx planned, no sense in Bx #urojc

DrHWoo
@DrRKSingaltegh @dytcmd Short of excising or ablating every SRM, do we have resources/expertise to manage the patient worry/anxiety #urojc

dytcmd
@DrHWoo @DrRKSingaltegh And we should have high bar to rec AS. Indication in the paper vague–most NOT for risk of CRI (ave eGFR >60)#urojc

DovePress
RT @DrRKSingaltegh@dytcmd Agreed. Paper suggests simply that worry/anxiety exist #urojc

DovePress
RT @uretericbud@_TheUrologist_ @urorao Dx of “benign” in frail / elderly = #gamechanger #urojc

johnleppert
@uretericbud @dytcmd @_theurologist_ @drrksingaltegh @urorao better estimates for pt life expectancy also integral to decision #urojc

DrRKSingaltegh
@dytcmd @DrHWoo our counsel frames everything. #urojc

iurojc
Can we justify moving this work on to a multicenter study with a control or comparative limb? RCT impossible/impractical? #urojc

iurojc
Are we just simply contributing to a growing population of worried well? #urojc

iurojc
RT @DrRKSingaltegh@dytcmd @DrHWoo our counsel frames everything. #urojc

iurojc
Take part in the March #urojc to win a free manuscript from @DovePress : http://t.co/h1bKK5g2T0

nickbrook12
@iurojc this popn is already there; others do the imaging, urols job is to steer correct management for incid SRM #urojc

DrHWoo
@penorthesword A tweet to the death is it? 🙂 #urojc

IsaacThangasamy
RT @iurojc: For quick review & reminder of topic, see attached abstract #urojc http://t.co/vhYoz7freJ

IsaacThangasamy
RT @StorkBrian@iurojc A great topic of study would be how much anxiety does following a small renal cause the urologist? #urojc

IsaacThangasamy
RT @DrRKSingaltegh@dytcmd @DrHWoo our counsel frames everything. #urojc

IsaacThangasamy
RT @iurojc: Take part in the March #urojc to win a free manuscript from @DovePress : http://t.co/h1bKK5g2T0

dytcmd
.@DrRKSingaltegh @drhwoo Agreed. The unmeasured variable of paper is what were patients told, and was it consistent btw docs. #urojc

_TheUrologist_
.@rhankb short answer no. UHN 1 case of benign->chromophobe. Key is not to interpret non-Dx as benign, as 80% RCC on repeat Bx #urojc

_TheUrologist_
@rhankb biopsy if known benign would avoid surgery. Not for all SRM for sure #urojc

rhankb
@_TheUrologist_ An incorrectly benign biopsy has potential implications on surveillance compliance. Why not forgo biopsy and follow #urojc

_TheUrologist_
Any uro-paths to weigh in on oncocytoma vs chromophobe on core Bx? Report usually “oncocytic mass, consistent w/ _X_” #urojc

DrRKSingaltegh
@dytcmd @IsaacThangasamy @uretericbud @_theurologist_ @urorao Well said Dave. Patients make best informed decisions on our lead #urojc

NeomedicInt
Needleless sling for Female SUI treatment: Single Incision (minimally invasive) TOT. http://t.co/IPO7gPDcfq #TOT #TVT #Minisling #urojc

iurojc
Calling on pathologists! MT “@_TheUrologist_: Any uro-paths to weigh in on oncocytoma vs chromophobe on core Bx? #urojc

iurojc
#urojc MT“@benchallacombe: The 17 who had a biopsy should be looked at separately. impact of a clinical psychologist on this?”

iurojc
@Williamson_SR @uropathology Are you able to help with our query? Follow #urojc discussion that is on right now

UrologieTwente
@daviesbj @upmcnews #urojc It is said round here “don’t make an elephant out of a mouse” what is right for one is wrong for another #rtx

njtouma
Must control for counselling session when looking at anxiety in AS pts. #urojc

Williamson_SR
@iurojc @_TheUrologist_ #urojc Controversial btw uropaths, our group is willing to call onco but this week at USCAP mtg some argue against

njtouma
How clinicians present Dx and implications likely big factor in provoking anxiety. #artofmedicine #urojc

njtouma
Trial itself is anxiety inducer: close & repeated calls by research team makes one think disease is life threatening! #urojc

iurojc
Int perspective MT @njtouma: Trial is anxiety inducer: close & repeated calls by research tm makes think disease is life threatening! #urojc

DovePress
RT @iurojc: Take part in the March #urojc to win a free manuscript from @DovePress : http://t.co/h1bKK5g2T0

DrHWoo
@benchallacombe 17/27 of biopsied had RCC. Interesting to look at those +ve or -ve biopsy results although numbers might be small #urojc

iurojc
What about percutaneous ablative techniques? Could they give some reassurance that something being done but not over top? Thoughts? #urojc

benchallacombe
@DrHWoo #urojc yes it may be to do with the uncertainty rather than living with “cancer” Counselling is key.

DrRKSingaltegh
@benchallacombe @DrHWoo Counselling and communication is absolutely the key and to my mind the only significant point of the paper #urojc

DrRKSingaltegh
@iurojc Doing ablative Rx simply 2 provide reassurance amounts 2 sham therapy. Treat appropriately & for AS, communicate effectively #urojc

DrRKSingaltegh
@IsaacThangasamy If only our #pancreaticcancer colleagues could have an AS discussion! GU cancers variable and unique #urojc

njtouma
Committing to ablation = committing to Rx; what’s the next step if ablation fails? Return to AS! #urojc

DrMarniqueB
QOL assessmt v useful in screening for high risks pts. Practically i suspect difficult to use to target psychosocial interventions #urojc

njtouma
Metaanalysis: Complications from ablative techniques up to 20% #notbenign #urojc http://t.co/x9abqS3EMg

daviesbj
@DrRKSingaltegh @isaacthangasamy #urojc I doubt our cancers are unique. See squam skin cancer, colon adenomas, cervical dysplasia, etc.

DrHWoo
@njtouma Post ablation, monitoring protocol similar to AS. Poss diff illness anxiety/QOL with Rx follow up vs potentially unRx tiger? #urojc

DrHWoo
@njtouma Devil in detail – MA of case series – pioneering/learning curve, some several years old, some old technology etc. #urojc

njtouma
.@DrHWoo agree that it may calm nerves! However, Other than ECT, this becomes only surgery with anxiety as indication! #urojc

_TheUrologist_
@njtouma @DrHWoo don’t forget HIFU for CaPr on that list of anxiolytic Tx. Whatta town! #urojc

dytcmd
@johnleppert @uretericbud @_theurologist_ @drrksingaltegh @urorao I think still too many variables and prediction will remain rough. #urojc

_TheUrologist_
@dytcmd @johnleppert @uretericbud @DrRKSingaltegh @urorao why don’t we just hire insurance underwriters to tell us? 😉 #urojc

iurojc
#urojc RT @KeithKow: Save the nephrons!! “Comparative effectiveness, costs and trends in treatment of SRMs” http://t.co/CH0nNjKZcR @qdtrinh

dytcmd
@_TheUrologist_ @johnleppert @uretericbud @drrksingaltegh @urorao That’s what I use: US Social Security life estimate tables! #urojc

DrRKSingaltegh
@dytcmd @_TheUrologist_ @johnleppert @uretericbud @urorao #urojc seems very reasonable to me

matthayn
@DrRKSingaltegh @dytcmd @_TheUrologist_ @johnleppert @uretericbud @urorao But need to adjust SS tables based on health status #urojc

lawrentschuk
#urojc paper proves cancer surveillance is all about pre-biopsy counseling. Tumour like polyp safer word, more buy in. We must lead on this!

IsaacThangasamy
@dytcmd @uretericbud @_theurologist_ @drrksingaltegh @urorao #urojc MT Surgeon’s counsel impt for bx or no bx, and what is the endgame?

IsaacThangasamy
@daviesbj @drrksingaltegh #urojc Ask the patients if cancer is unique. Philosophical… But I get what you’re saying.

DrRKSingaltegh
@daviesbj @isaacthangasamy If we are now counting some #GUcancers with this group it further highlights how much we overtreated B4 #urojc

iurojc
RT @lawrentschuk#urojc paper proves cancer surveillance is all about pre-biopsy counseling. Tumour like polyp safer word, more buy in. …

daviesbj
@lawrentschuk #urojc you spell tumor funny

DrRKSingaltegh
@wandering_gu @dytcmd @_TheUrologist_ @uretericbud @urorao Agreed. I shared this a few days ago as well. Nice algorithm #urojc

wandering_gu
@DrRKSingaltegh @benchallacombe @DrHWoo As with prostate biopsy, AS/WW counseling needs to begin before SRM biopsy–setup is the key.#urojc

wandering_gu
RT @lawrentschuk#urojc paper proves cancer surveillance is all about pre-biopsy counseling. Tumour like polyp safer word, more buy in. …

DrHWoo
@daviesbj It is not a tumor! #urojc

dytcmd
@IsaacThangasamy @uretericbud @_theurologist_ @drrksingaltegh @urorao It not impt for bx/no bx but for rx or AS. To bx just 1 part. #urojc

johnleppert
@dytcmd @_theurologist_ @uretericbud @drrksingaltegh @urorao try http://t.co/Tum44Ayk6z and Jama review http://t.co/R3DCZuRDlp #urojc

urorao
#urojc Take home msg: urologists good at counselling AS in CaP but poor at counselling AS in renal lesions! #urologybeyondprostate

iurojc
RT @urorao#urojc Take home msg: urologists good at counselling AS in CaP but poor at counselling AS in renal lesions! #urologybeyondp …

iurojc
Any other take home messages as you see it from this study? #urojc http://t.co/3WUJMWp7Oy

iurojc
This exc paper on SRM Rx by @keithkow @qdtrinh is hot off press on @BJUIjournal http://t.co/CH0nNjKZcR & highly relevant to this #urojc

iurojc
This piece on SRMs published in @NatRevUrol on line today is also highly relevant to this #urojc – SRM discussion is flavour of the month

UrologieTwente
@urorao there is no prostate sparing operation for Pca unfortunaty 😉 We love nefronsparing! #ZGT #urojc

DrHWoo
@BladderCancerUK Often the concern is “when will the cancer progress” and “will I miss the boat”. We need to counsel better #urojc

_TheUrologist_
@iurojc pts who will be miserable & terrified will not thrive on SRM surveillance. Should factor in Tx decision if all options open #urojc

iurojc
About 15 minutes to go for any final final comments in the March #urojc paper! http://t.co/nooU21fFFu

urorao
#urojc Dbate on QoL in Mx SRM has just began. Wil see a series of papers in the near future. b ready 2 discus a few more in months 2 come!

 

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